It has been suggested that clinically relevant portal hypertension may affect the management and prognosis of cirrhotic patients with hepatocellular carcinoma.
Nevertheless, the importance of the presence of esophageal varices in these patients has not yet been addressed formally.
Dr Eugenio Caturelli and colleagues from Italy evaluated the prevalence and prognostic relevance of esophageal varices in a large series of patients with hepatocellular carcinoma.
The prevalence of esophageal varices was evaluated in 1153 hepatocellular carcinoma patients who were consecutively referred to 10 Italian centers.
Survival was calculated from the time of hepatocellular carcinoma diagnosis until death or until the most recent follow-up visit.
| Esophageal varices were found in 63% of patients|
|Clinical Gastroenterology & Hepatology|
The investigative team evaluated survival according to the presence or absence of esophageal varices.
The independent prognostic meaning of the presence of esophageal varices was evaluated further in a multivariate regression analysis.
The investigators found esophageal varices in 63% of patients.
The team observed that patients with varices showed significantly shorter survival times as compared with patients without varices.
The investigators noted that death as a result of bleeding was more common in patients with varices.
In multivariate analysis, the presence of esophageal varices was associated independently with poorer survival.
Dr Caturelli's team commented, “More than half of the patients with hepatocellular carcinoma have esophageal varices.”
“The presence of esophageal varices is associated with a higher risk of death from bleeding, and is an independent determinant of the patient's prognosis.”
“This variable should be taken into account in the diagnostic and therapeutic work-up of hepatocellular carcinoma patients.”